Workers' Certified Nurse Case Manager

Location: Oak Ridge, TN
Job Title: Workers' Compensation Certified Nurse Case Manager
Career Level:Senior Specialist
Job Specialty: Workers' Compensation Case Management

• Gather relevant information to assist in the investigation and evaluation of workers’ compensation claims through interviews, verbal or written communications, and medical records.
• Responsible for helping to ensure injured parties receive appropriate treatment directly related to their compensable injury.
• Attends medical appointments with injured employees.
• Communicates in person and by telephone with patients, medical providers, attorneys, and insurance carrier to provide ongoing case management.
• Works collaboratively with claim handlers/adjusters to ensure that all injured parties are on an appropriate treatment plan and to manage medical treatment to resolution. Participate in periodic claim reviews.
• Work with others in a tactful, congenial, and professional manner so as to gain their trust and cooperation and accomplish assigned tasks.
• Exchange ideas, information, and opinions with others to jointly arrive at decisions, conclusions, solutions, or otherwise solve disputes.
• Responsible for ongoing evaluation of treatment or return to work plan within established protocols.
• Interact with Occupational Health Services (OHS) and Environmental Safety &Health (ES&H) to obtain or clarify clinical information and participate in in-house case reviews.
• Maintain high standard of file documentation to ensure attention to detail and file accuracy, and provide timely reports, responses, and case updates.
• Provide comprehensive medical case management oversight of workers’ compensation claims.
• Advocate for appropriate services and treatment to attain best practices standards, maximum medical improvement and successful return-to-work.
• Communicate with employees, line management, Occupational Health Services (OHS), occupational safety and health administration (OSHA) recordkeeping, benefits, internal and external counsel, external providers, and others to ensure understanding of, and cooperation with, the recommended treatment plans and the goal of returning employees to meaningful work.
• Maintain required continuing education as outlined by CCM, TN Bureau of Workers’ Compensation, and CNS.

• Meaningful work and unique opportunities to support missions vital to national and global security
• Top-notch, dedicated colleagues
• Generous pay and benefits with a stable organization
• Career advancement and professional development programs
• Work-life balance fostered through flexible work options and wellness initiatives
• Bachelor’s degree:
  Minimum 7 years of relevant experience as a workers’ compensation nurse case manager. Typical experience ranging from 10 to 15 years.
• RN with current state license required
• CCM certification required

• Knowledge of and working familiarity with the Official Disability Guidelines (ODG)
• Knowledge of and working familiarity with the MD Guidelines
• Documentation and calculation of cost savings per case
• Strong problem solving and analytical skills
• Excellent interpersonal, oral, and written communication skills
• Good computer skills including use of Word and Excel
• Ability to interface with treating physicians, division managers, OHS staff, and employees

You get #morethanajob. We encourage employees to achieve a healthy personal balance among home, work and the community. One of the ways we embrace work-life balance is by offering flexible work arrangements that provide alternatives to the traditional workweek, while still meeting business needs. Top talent and personal commitment mean more to our success than any other factors, so we reward our people with the kinds of benefits that…